Stages of vulvar cancer

Staging describes or classifies a cancer based on how much cancer there is in the body and where it is when first diagnosed. This is often called the extent of cancer. Information from tests is used to find out the size of the tumour, whether the cancer has spread from where it first started and where the cancer has spread. Your healthcare team uses the stage to plan treatment and estimate the outcome (your prognosis).

The most common staging system for vulvar cancer is the FIGO system. For vulvar cancer there are 4 stages. Often the stages 1 to 4 are written as the Roman numerals I, II, III and IV. Generally, the higher the stage number, the more the cancer has spread. Talk to your doctor if you have questions about staging.

Vulvar cancer is often staged when surgery is done to remove the cancer. Other tissue will be removed, and these samples will be tested for cancer. The stage depends on the results of the tests.

Find out more about staging cancer.

Stage 1

The tumour is only in the vulva or is only in the vulva and the perineum (the area between the vagina and anus). Stage 1 can be divided into stages 1A and 1B depending on the size of the tumour and how much the tumour has grown into surrounding tissues, such as connective tissue, blood vessels and nerves.

Stage 2

The tumour has grown into nearby areas, such as the lower part of the urethra, the lower part of the vagina or the anus.

Stage 3

The cancer has spread to nearby lymph nodes in the groin. Stage 3 can be divided into stages 3A, 3B and 3C depending on how many of the lymph nodes contain cancer and the size of the lymph nodes.

Stage 4

Stage 4 can be one of the following:

  • The cancer has spread to nearby lymph nodes in the groin. These lymph nodes are firmly attached to surrounding tissues (fixed) or have broken open (ulcerated) (stage 4A).
  • The tumour has grown into nearby areas, such as the upper part of the urethra, the upper part of the vagina, the inner lining of the bladder or the inner lining of the rectum. Or the tumour has attached to the pelvic bone (stage 4A).
  • The cancer has spread to other parts of the body, such as to the lungs or lymph nodes in the pelvis (stage 4B). This is also called metastatic vulvar cancer.

Recurrent vulvar cancer

Recurrent vulvar cancer means that the cancer has come back after it has been treated. If it comes back in the same place that the cancer first started, it’s called local recurrence. It can also recur in another part of the body. This is called distant metastasis or distant recurrence.

Expert review and references

  • Brierley JD, Gospodarowicz MK, Wittekind C (eds.). TNM Classification of Malignant Tumours. 8th ed. Wiley Blackwell; 2017.
  • FIGO Committee on Gynecologic Oncology . Revised FIGO staging for carcinoma of the vulva, cervix, and endometrium. International Journal of Gynecology and Obstetrics. 2009: 105:103–104.

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